Abstract:
Objective To investigate the prognostic factors of acute pancreatitis and establish a nomogram model to predict the survival rate of patients with acute pancreatitis.
Methods A total of 398 patients who were diagnosed with acute pancreatitis in the Affiliated Hospital of Xuzhou Medical University from February 2021 to May 2022 were selected as an internal validation group for retrospective analysis, while another 150 patients were selected for external validation. The patients were divided into two groups: a death group and a survival group. The multivariate logistic regression analysis was performed and the prognostic nutrition index(PNI), systematic immunoinflammatory index(SII) and modified bedside index of severity in acute pancreatitis(MBISAP) score were adopted to construct a nomogram model and draw the calibration curve for verification. The net reclassification index(NRI) and the comprehensive discriminant improvement index(IDI) was used to evaluate the predictive efficiency. Kaplan-Meier curves were plotted.
Results Compared with the survival group, the death group showed increases in blood urea, neutrophils, SII score, MBISAP score, the number of patients with pleural effusion, and the proportion of SIRS(
P<0.05), and decreases in albumin and PNI scores(
P<0.05). Multivariate prognostic analysis suggested that MBISAP, PNI and SII were independent prognostic factors of acute pancreatitis. The risk stratification of the nomogram model score suggested that the 28-day fatality rate was higher in the high-risk group(total score >67)(
P<0.05).
Conclusions Based on MBISAP score, PNI and SII, the reliable nomogram model was constructed, which has good prognostic and risk stratification value for acute pancreatitis patients.